In the INDIGO trial, vorasidenib, an oral IDH 1/2 inhibitor, significantly prolonged median PFS and time to next intervention compared to observation in patients with IDH-mutated grade 2 glioma who did not receive immediate adjuvant therapy after surgery. In this report of secondary and exploratory endpoints, tumor volumetric growth was -1.3% on vorasidenib vs +15.9% with observation. Seizure control was also better with vorasidenib (18.2 v 51.2 seizures per person year). However, treatment with vorasidenib did not significantly improve any patient reported quality of life outcomes or measures of neurocognitive and psychomotor function. Unfortunately, this report doesn’t really help with the mental gymnastics required to select high risk patients (those with gross disease) in which upfront chemoradiation (which improves survival, by the way) is not preferred. | Cloughesy, Lancet Oncol 2025
